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Cecal bascule – A rare cause of cecal volvulus after cesarean section

INTRODUCTION AND IMPORTANCE: Cecal bascule is a rare form of a cecal volvulus characterized by an anterior and superiorly displaced cecum in turn causing compression of the ascending colon that can result in a large bowel obstruction. We report a case of cecal bascule in a newly postpartum patient,...

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Autores principales: Bakshi, Chetna, Pereira, Xavier, Massad, Nicole, Lima, Diego Laurentino, Peskin-Stolze, Melissa, Malcher, Flavio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278416/
https://www.ncbi.nlm.nih.gov/pubmed/34247120
http://dx.doi.org/10.1016/j.ijscr.2021.106168
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author Bakshi, Chetna
Pereira, Xavier
Massad, Nicole
Lima, Diego Laurentino
Peskin-Stolze, Melissa
Malcher, Flavio
author_facet Bakshi, Chetna
Pereira, Xavier
Massad, Nicole
Lima, Diego Laurentino
Peskin-Stolze, Melissa
Malcher, Flavio
author_sort Bakshi, Chetna
collection PubMed
description INTRODUCTION AND IMPORTANCE: Cecal bascule is a rare form of a cecal volvulus characterized by an anterior and superiorly displaced cecum in turn causing compression of the ascending colon that can result in a large bowel obstruction. We report a case of cecal bascule in a newly postpartum patient, with emphasis on clinical presentation, radiologic findings and treatment. CASE PRESENTATION: A 37-year-old female who underwent an uncomplicated c-section and bilateral salpingectomy developed severe abdominal pain, vomiting, and peritonitis 12 h after surgery. A computerized tomography of the abdomen and pelvis revealed a dilated and superiorly displaced cecum. The diagnosis of cecal bascule was confirmed intraoperatively and a right hemicolectomy was performed. The patient recovered appropriately and was discharged on postoperative day six. DISCUSSION: Cecal bascule is the rarest form of cecal volvulus. In the context of obstetrics and gynecology, it has mostly been mentioned perioperatively after cesarean, but was also reported in an antepartum patient. It usually occurs in patients with redundant or mobile cecum, which is a result of incomplete fixation of the cecum to the retroperitoneum during embryogenesis. Other risk factors include recent surgery, previous abdominal surgery, ileus, chronic constipation, and distal colonic obstruction. An association has also been shown with pregnancy or the postpartum abdomen and is hypothesized to be due to mass effect. CONCLUSION: Cecal bascule is a serious entity requiring a high index of suspicion and warranting greater awareness in the post-natal patient. Clinical diagnosis, prompt imaging, and surgery are important to avoid bowel ischemia and perforation.
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spelling pubmed-82784162021-07-19 Cecal bascule – A rare cause of cecal volvulus after cesarean section Bakshi, Chetna Pereira, Xavier Massad, Nicole Lima, Diego Laurentino Peskin-Stolze, Melissa Malcher, Flavio Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Cecal bascule is a rare form of a cecal volvulus characterized by an anterior and superiorly displaced cecum in turn causing compression of the ascending colon that can result in a large bowel obstruction. We report a case of cecal bascule in a newly postpartum patient, with emphasis on clinical presentation, radiologic findings and treatment. CASE PRESENTATION: A 37-year-old female who underwent an uncomplicated c-section and bilateral salpingectomy developed severe abdominal pain, vomiting, and peritonitis 12 h after surgery. A computerized tomography of the abdomen and pelvis revealed a dilated and superiorly displaced cecum. The diagnosis of cecal bascule was confirmed intraoperatively and a right hemicolectomy was performed. The patient recovered appropriately and was discharged on postoperative day six. DISCUSSION: Cecal bascule is the rarest form of cecal volvulus. In the context of obstetrics and gynecology, it has mostly been mentioned perioperatively after cesarean, but was also reported in an antepartum patient. It usually occurs in patients with redundant or mobile cecum, which is a result of incomplete fixation of the cecum to the retroperitoneum during embryogenesis. Other risk factors include recent surgery, previous abdominal surgery, ileus, chronic constipation, and distal colonic obstruction. An association has also been shown with pregnancy or the postpartum abdomen and is hypothesized to be due to mass effect. CONCLUSION: Cecal bascule is a serious entity requiring a high index of suspicion and warranting greater awareness in the post-natal patient. Clinical diagnosis, prompt imaging, and surgery are important to avoid bowel ischemia and perforation. Elsevier 2021-07-03 /pmc/articles/PMC8278416/ /pubmed/34247120 http://dx.doi.org/10.1016/j.ijscr.2021.106168 Text en © 2021 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Bakshi, Chetna
Pereira, Xavier
Massad, Nicole
Lima, Diego Laurentino
Peskin-Stolze, Melissa
Malcher, Flavio
Cecal bascule – A rare cause of cecal volvulus after cesarean section
title Cecal bascule – A rare cause of cecal volvulus after cesarean section
title_full Cecal bascule – A rare cause of cecal volvulus after cesarean section
title_fullStr Cecal bascule – A rare cause of cecal volvulus after cesarean section
title_full_unstemmed Cecal bascule – A rare cause of cecal volvulus after cesarean section
title_short Cecal bascule – A rare cause of cecal volvulus after cesarean section
title_sort cecal bascule – a rare cause of cecal volvulus after cesarean section
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278416/
https://www.ncbi.nlm.nih.gov/pubmed/34247120
http://dx.doi.org/10.1016/j.ijscr.2021.106168
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